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Recommendations On Nmosd Treatment In Latin America: Consensus-Based Rand/Ucla Methodology

Nicolas Alonso, Ricardo
[1]; 
Rivera, Visctor
[2]; 
German, Edgar
[3]; 
Contentti, Carnero
[4]; 
Diaz de Bedoya, Victor Fernando Hamuy
[5]; 
Ciampi, Ethel
[6]; 
Silva, Berenice
[7]; 
Zuluaga, Maria
[8]; 
Becker, Jefferson
[9]; 
Ignacio Rojas, Juan
[10]; 
Gracia, Fernando
[11]; 
Zarco, Luis
[12]; 
Analia Tkachuk, Veronica
[13]; 
Molt, Fernando
[14]; 
Soto, Ibis
[15]; 
Fernandez Calderon, Ramiro Nolberto
[15]; 
Adrian Lopez, Pablo
[9]; 
Patrucco, Liliana
[16]; 
Trevino-Frenk, Irene
[8]; 
Sato, Douglas Kazutoshi
[17]; 
Ramirez, Deyanira
[18]; 
Navas, Carlos
[19]; 
Fujihara, Kazuo
[20]; 
Galleguillos, Lorna
  • 1
    Hospital Ramos Mejia; Hosp Univ Sanatorio Guemes
  • 2
    Baylor College of Medicine
  • 3
    University of Buenos Aires
  • 4
    Hosp IMT
  • 5
    Pontificia Universidad Catolica de Chile
  • 6
    Hospital Ramos Mejia; Hospital Italiano de Buenos Aires
  • 7
    Mutilple Sclerosis Ctr Medicarte
  • 8
    Pontificia Universidade Catolica Do Rio Grande Do Sul
  • 9
    CEMBA
  • 10
    Hosp Santo Tomas
  • 11
    Hospital Universitario San Ignacio
  • 12
    Hospital de Clinicas Jose de San Martin
  • 13
    Hosp San Pablo Coquimbo
  • 14
    Hosp Univ Maracaibo
  • 15
    Universidad de Magallanes
  • 16
    Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran - Mexico
  • 17
    Hosp Docente Padre Billini
  • 18
    Clin Univ Colombia
  • 19
    Tohoku University
  • 20
    Clinica Davila; Clinica Alemana
DOI
Date Issued
2023-10
Type
Artículo
Journal
Multiple Sclerosis Journal
ISSN
1352-4585
Open Access
closed
Volume
94
Start page
948
End page
949
Links
Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a serious condition affecting people worldwide, including Latin America (LATAM). Healthcare disparities and economic limitations make effective treatment access challenging. It is crucial to consider the best practice therapeutic decision-making, including emerging long-term preventive therapies, to ensure patients in LATAM and elsewhere can effectively manage their disease all over the world. Objectives/Aims: To establish evidence-based guidelines for treatment approaches in NMOSD patients in LATAM. A consensus process was conducted to develop validated statements. Methods: A group of NMOSD experts from LATAM utilized a 9-point Likert scale to vote on statements related to NMOSD management. The predetermined consensus threshold was set at a minimum expert agreement of 70 %. The RAND/UCLA methodology was employed to reach consensus recommendations. Results: Nineteen experts completed the consensus process between March and April 2023. In round 1, no statement failed to reach the predetermined consensus, resulting in 31 agreed statements. The statements were divided between general recommendations (14/31) and clinical scenarios (17/31). The scenarios were based on treatment-na & iuml;ve NMOSD AQP4 positive patients (4/17); treatment-naive seronegative NMOSD patients (4/17); treatment switching (5/17) and safety (4/17). Conclusions: Consensus recommendations were developed on the most important areas of NMOSD treatment by a panel of experts in LATAM. These statements are a valuable tool to guide decision-making and improve patient outcomes, serving as the foundation for developing standardized practice guidelines in our region.
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